tbuckley/cabot-search huggingface dataset:
Primary Care Continuity, Frequency, and Regularity Associated With Medicare Savings
Authors: Dilara Sonmez, George Weyer, Daniel Adelman
Journal: JAMA Network Open (2023)

Reducing Medicare expenditures is a key objective of Medicare's transition to value-based reimbursement models. Improving access to primary care is an important way to reduce expenditures, yet less is known about how visits should be organized to maximize savings.To examine the association between Medicare savings and primary care visit patterns.This retrospective cohort study used data from a 5% sample of traditional Medicare claims from 2016 to 2019. Participants had at least 3 primary care visits with at least 180 days between the first and the last visit, were not enrolled in Medicare Advantage, did not have end-stage kidney disease, and were not institutionalized. Data were analyzed from June 2022 to April 2023.Primary care visit patterns: visit frequency, regularity, continuity of care.Savings in Medicare expenditures; risk-adjusted Medicare expenditures, number of emergency department (ED) visits, and hospitalizations.Among 504 471 beneficiaries (298 422 [59.16%] women; mean [SD] age, 74.26 [10.41] years), temporally regular visits with higher continuity were associated with the highest savings. For these patients, the savings increased with increasing visit frequencies, with peak savings observed at higher visit frequencies as clinical complexity increased. As regularity and continuity decreased, the association between savings and visit frequencies progressively inverted. The group with a regular and highly continuous pattern was associated with greater savings (175.87%; 95% CI, 167.40% to 184.33%; P < .001), lower risk-adjusted expenditures (-16.61%; 95% CI, -16.73% to -16.48%; P < .001), fewer risk-adjusted ED visits (-40.49%; 95% CI, -40.55% to -40.43%; P < .001), and fewer risk-adjusted hospitalizations (-53.32%; 95% CI, -53.49% to -53.14%; P < .001) compared with the irregular noncontinuous group.In this cohort study, savings in Medicare expenditures and improvements in acute care utilization were associated with visit frequency, regularity, and continuity in primary care in an interrelated fashion such that optimization of primary care visit patterns along each axis were associated with the largest improvement in outcomes. Demonstrating the magnitude and interdependence of these associations is useful for health care professionals and policymakers as Medicare continues its transition to value-based reimbursement models.
DNA Methylation-Based Testing in Peripheral Blood Mononuclear Cells Enables Accurate and Early Detection of Colorectal Cancer
Authors: Yan Xie, Peilong Li, Dong Sun, Qiuchen Qi, Suhong Ma, Yinghui Zhao, Shujun Zhang, Tiantian Wang, Jing Wang, Shijun Li, Tingting Gong, Huiting Xu, Mengqiu Xiong, Guanghua Li, Chongge You, Zhaofan Luo, Juan Li, Chuanxin Wang, Lutao Du
Journal: Cancer Research (2023)

An effective blood-based method for the diagnosis of colorectal cancer has not yet been developed. Molecular alterations of immune cells occur early in tumorigenesis, providing the theoretical underpinning for early cancer diagnosis based on immune cell profiling. Therefore, we aimed to develop an effective detection method based on peripheral blood mononuclear cells (PBMC) to improve the diagnosis of colorectal cancer. Analysis of the genome-wide methylation landscape of PBMCs from patients with colorectal cancer and healthy controls by microarray, pyrosequencing, and targeted bisulfite sequencing revealed five DNA methylation markers for colorectal cancer diagnosis, especially early-stage colorectal cancer. A single-tube multiple methylation-specific quantitative PCR assay (multi-msqPCR) for simultaneous detection of five methylation markers was established, which allowed quantitative analysis of samples with as little as 0.1% PBMC DNA and had better discriminative performance than single-molecule detection. Then, a colorectal cancer diagnostic model (CDM) based on methylation markers and the multi-msqPCR method was constructed that achieved high accuracy for early-stage colorectal cancer (AUC = 0.91; sensitivity = 81.18%; specificity = 89.39%), which was improved compared with CEA (AUC = 0.79). The CDM also enabled a high degree of discrimination for advanced adenoma cases (AUC = 0.85; sensitivity = 63.04%). Follow-up data also demonstrated that the CDM could identify colorectal cancer potential up to 2 years before currently used diagnostic methods. In conclusion, the approach constructed in this study based on PBMC-derived DNA methylation markers and a multi-msqPCR method is a promising and easily implementable diagnostic method for early-stage colorectal cancer.Development of a diagnostic model for early colorectal cancer based on epigenetic analysis of PBMCs supports the utility of altered DNA methylation in immune cells for cancer diagnosis.
Effects of Dupilumab on Mucus Plugging and Ventilation Defects in Patients with Moderate-to-Severe Asthma: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Sarah Svenningsen, Melanie Kjarsgaard, Ehsan Haider, Carmen Venegas, Norman Konyer, Yonni Friedlander, Neha Nasir, Colm Boylan, Miranda Kirby, Parameswaran Nair
Journal: American Journal of Respiratory and Critical Care Medicine (2023)
Inhibition of galectin-3 post-infarction impedes progressive fibrosis by regulating inflammatory profibrotic cascades
Authors: Xiaoyin Wang, Meenakshi Gaur, Khalid Mounzih, Hilda J Rodriguez, Huiliang Qiu, Ming Chen, Liqiu Yan, Brian A Cooper, Shilpa Narayan, Ronak Derakhshandeh, Poonam Rao, Daniel D Han, Pooneh Nabavizadeh, Matthew L Springer, Constance M John
Journal: Cardiovascular Research (2023)

Abstract Aims Acute myocardial infarction (MI) causes inflammation, collagen deposition, and reparative fibrosis in response to myocyte death and, subsequently, a pathological myocardial remodelling process characterized by excessive interstitial fibrosis, driving heart failure (HF). Nonetheless, how or when to limit excessive fibrosis for therapeutic purposes remains uncertain. Galectin-3, a major mediator of organ fibrosis, promotes cardiac fibrosis and remodelling. We performed a preclinical assessment of a protein inhibitor of galectin-3 (its C-terminal domain, Gal-3C) to limit excessive fibrosis resulting from MI and prevent ventricular enlargement and HF. Methods and results Gal-3C was produced by enzymatic cleavage of full-length galectin-3 or by direct expression of the truncated form in Escherichia coli. Gal-3C was intravenously administered for 7 days in acute MI models of young and aged rats, starting either pre-MI or 4 days post-MI. Echocardiography, haemodynamics, histology, and molecular and cellular analyses were performed to assess post-MI cardiac functionality and pathological fibrotic progression. Gal-3C profoundly benefitted left ventricular ejection fraction, end-systolic and end-diastolic volumes, haemodynamic parameters, infarct scar size, and interstitial fibrosis, with better therapeutic efficacy than losartan and spironolactone monotherapies over the 56-day study. Gal-3C therapy in post-MI aged rats substantially improved pump function and attenuated ventricular dilation, preventing progressive HF. Gal-3C in vitro treatment of M2-polarized macrophage-like cells reduced their M2-phenotypic expression of arginase-1 and interleukin-10. Gal-3C inhibited M2 polarization of cardiac macrophages during reparative response post-MI. Gal-3C impeded progressive fibrosis post-MI by down-regulating galectin-3-mediated profibrotic signalling cascades including a reduction in endogenous arginase-1 and inducible nitric oxide synthase (iNOS). Conclusion Gal-3C treatment improved long-term cardiac function post-MI by reduction in the wound-healing response, and inhibition of inflammatory fibrogenic signalling to avert an augmentation of fibrosis in the periinfarct region. Thus, Gal-3C treatment prevented the infarcted heart from extensive fibrosis that accelerates the development of HF, providing a potential targeted therapy.
Improved Cardiac Function in Postischemic Rats Using an Optimized Cardiac Reprogramming Cocktail Delivered in a Single Novel Adeno-Associated Virus
Authors: Huanyu Zhou, Jin Yang, Chetan Srinath, Aliya Zeng, Iris Wu, Elena C. Leon, Tawny Neal Qureshi, Christopher A. Reid, Emily R. Nettesheim, Emma Xu, Zoe Duclos, Tamer M.A. Mohamed, Farshad Farshidfar, Anthony Fejes, Jun Liu, Samantha Jones, Charles Feathers, Tae Won Chung, Frank Jing, William S. Prince, JianMin Lin, Pengzhi Yu, Deepak Srivastava, Timothy Hoey, Kathryn N. Ivey, Laura M. Lombardi
Journal: Circulation (2023)

Cardiac reprogramming is a technique to directly convert nonmyocytes into myocardial cells using genes or small molecules. This intervention provides functional benefit to the rodent heart when delivered at the time of myocardial infarction or activated transgenically up to 4 weeks after myocardial infarction. Yet, several hurdles have prevented the advancement of cardiac reprogramming for clinical use.Through a combination of screening and rational design, we identified a cardiac reprogramming cocktail that can be encoded in a single adeno-associated virus. We also created a novel adeno-associated virus capsid that can transduce cardiac fibroblasts more efficiently than available parental serotypes by mutating posttranslationally modified capsid residues. Because a constitutive promoter was needed to drive high expression of these cell fate-altering reprogramming factors, we included binding sites to a cardiomyocyte-restricted microRNA within the 3' untranslated region of the expression cassette that limits expression to nonmyocytes. After optimizing this expression cassette to reprogram human cardiac fibroblasts into induced cardiomyocyte-like cells in vitro, we also tested the ability of this capsid/cassette combination to confer functional benefit in acute mouse myocardial infarction and chronic rat myocardial infarction models.We demonstrated sustained, dose-dependent improvement in cardiac function when treating a rat model 2 weeks after myocardial infarction, showing that cardiac reprogramming, when delivered in a single, clinically relevant adeno-associated virus vector, can support functional improvement in the postremodeled heart. This benefit was not observed with GFP (green fluorescent protein) or a hepatocyte reprogramming cocktail and was achieved even in the presence of immunosuppression, supporting myocyte formation as the underlying mechanism.Collectively, these results advance the application of cardiac reprogramming gene therapy as a viable therapeutic approach to treat chronic heart failure resulting from ischemic injury.
Effect of Bypassing the Closest Stroke Center in Patients with Intracerebral Hemorrhage
Authors: Anna Ramos-Pachón, David Rodríguez-Luna, Joan Martí-Fàbregas, Mònica Millán, Alejandro Bustamante, Marina Martínez-Sánchez, Joaquín Serena, Mikel Terceño, Carla Vera-Cáceres, Pol Camps-Renom, Luis Prats-Sánchez, Noelia Rodríguez-Villatoro, Pere Cardona-Portela, Xabier Urra, Silvia Solà, Maria del Mar Escudero, Mercè Salvat-Plana, Marc Ribó, Sònia Abilleira, Natalia Pérez de la Ossa, Yolanda Silva, Ana Rodríguez-Campello, Francesc Purroy, Xavier Ustrell, Moisés Garcés, Júlia Saura, Jerzy Krupinski, David Cánovas, Sònia García-Sánchez, Esther Catena, Piera Carla Sergio, Elsa Puiggròs, Iñigo Soteras, Núria López, Ana Cabanelas, Eduard Sanjurjo, Mercè López, Ernest Palomeras, Laura Redondo, Dolores Cocho, Dolors Carrión, Anabel López, Montserrat Gorchs, Xavier Jiménez-Fàbrega, Rosa Vivanco, Josep Ros, Verónica Hidalgo, Guillem Gallofré
Journal: JAMA Neurology (2023)

Prehospital transfer protocols are based on rapid access to reperfusion therapies for patients with ischemic stroke. The effect of different protocols among patients receiving a final diagnosis of intracerebral hemorrhage (ICH) is unknown.
Infection with alternate frequencies of SARS-CoV-2 vaccine boosting for patients undergoing antineoplastic cancer treatments
Authors: Jeffrey P Townsend, Hayley B Hassler, Brinda Emu, Alex Dornburg
Journal: JNCI Journal of the National Cancer Institute (2023)

Abstract Patients undergoing antineoplastic therapies often exhibit reduced immune response to COVID-19 vaccination, necessitating assessment of alternate booster vaccination frequencies. However, data on reinfection risks to guide clinical decision making are limited. Here, we quantified reinfection risks for patients undergoing distinct antineoplastic therapies, given alternative frequencies of boosting with Pfizer-BioNTech BNT162b2. Integrating antibody data following vaccination with long-term antibody data from other coronaviruses in an evolutionary framework, we estimated infection probabilities based on antibody levels and calculated cumulative probabilities of breakthrough infection for alternate booster schedules over 2 years. Annual boosting reduced risks for targeted or hormonal treatments, immunotherapy, and chemotherapy-immunotherapy combinations similarly to the general population. Patients receiving no treatment or chemotherapy exhibited higher risks, suggesting that accelerated vaccination schedules should be considered. Patients treated with rituximab therapy presented the highest infection risk, suggesting that a combination of frequent boosting and additional interventions may be warranted for mitigating SARS-CoV-2 infection.
Unique Device Identifiers—Missing in Action
Authors: Vinay K. Rathi, Joseph S. Ross, Rita F. Redberg
Journal: JAMA Internal Medicine (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Reexamining Quality Assessment and Effect Size Reporting Among Studies Showing Major Changes in Depressive Symptoms
Authors: Michael Daly
Journal: JAMA Pediatrics (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Arrhythmia During Anaphylaxis—An Intrinsic or Extrinsic Cause?
Authors: Vickram Vignesh Rangaswamy, Aparna Velmurugan, S. Balaji
Journal: JAMA Internal Medicine (2023)

A patient in their 50s presented to the emergency department (ER) within 30 minutes of ingestion of prawns at a restaurant with complaints of an itchy skin rash, and generalized weakness; his pulse rate was 79 bpm, his blood pressure was 50/30 mm Hg, and his respiratory rate was 20 per minute. What is your diagnosis?
Fn‐HMGB1 Adsorption Behavior Initiates Early Immune Recognition and Subsequent Osteoinduction of Biomaterials
Authors: Qin Zhao, Zifan Zhao, Jing Zhang, Yueqi Ni, Simin Ouyang, Haoning Qi, Yiqian Yu, Richard J. Miron, Hua Tang, Yufeng Zhang
Journal: Advanced Healthcare Materials (2023)

Abstract Implantable biomaterials are widely used in bone tissue engineering, but little is still known about how they initiate early immune recognition and the initial dynamics. Herein, the early immune recognition and subsequent osteoinduction of biphasic calcium phosphate (BCP) after implantation to the protein adsorption behavior is attributed. By liquid chromatography tandem mass spectrometry (LC‒MS/MS) analysis, the biomaterial‐related molecular patterns (BAMPs) formed after BCP implantation are mapped, dominated by the highly expressed extracellular matrix protein fibronectin (Fn) and the high mobility group box 1 (HMGB1). Molecular dynamics simulations show that Fn has the ability to bind more readily to the BCP surface than HMGB1. The preferential binding of Fn provides a higher adsorption energy for HMGB1. Furthermore, multiple hydrogen bonding sites between HMGB1 and Fn are demonstrated using a molecular docking approach. Ultimately, the formation of BAMPs through HMGB1 antagonist glycyrrhizic acid (GA), resulting in impaired immune recognition of myeloid differentiation factor 88 (MYD88) mediated dendritic cells (DCs) and macrophages (Mφs), as well as failed osteoinduction processes is obstructed. This study introduces a mechanism for early immune recognition of implant materials based on protein adsorption, providing perspectives for future design and application of tissue engineering materials.
Arteriosclerosis Assessment Based on Single‐Point Fingertip Pulse Monitoring Using a Wearable Iontronic Sensor
Authors: Yi Huang, Lingyu Zhao, Minkun Cai, Jiaqi Zhu, Liu Wang, Xinxing Chen, Yumin Zeng, Liqing Zhang, Jidong Shi, Chuan Fei Guo
Journal: Advanced Healthcare Materials (2023)

Arteriosclerosis, which appears as a hardened and narrowed artery with plaque buildup, is the primary cause of various cardiovascular diseases such as stroke. Arteriosclerosis is often evaluated by clinically measuring the pulse wave velocity (PWV) using a two-point approach that requires bulky medical equipment and a skilled operator. Although wearable photoplethysmographic sensors for PWV monitoring are developed in recent years, likewise, this technique is often based on two-point measurement, and the signal can easily be interfered with by natural light. Herein, a single-point strategy is reported based on stable fingertip pulse monitoring using a flexible iontronic pressure sensor for heart-fingertip PWV (hfPWV) measurement. The iontronic sensor exhibits a high pressure-resolution on the order of 0.1 Pa over a wide linearity range, allowing the capture of characteristic peaks of fingertip pulse waves. The forward and reflected waves of the pulse are extracted and the time difference between the two waves is computed for hfPWV measurement using Hiroshi's method. Furthermore, a hfPWV-based model is established for arteriosclerosis evaluation with an accuracy comparable to that of existing clinical criteria, and the validity of the model is verified clinically. The work provides a reliable technique that can be used in wearable arteriosclerosis assessment systems.
Error in Figures
Journal: JAMA Neurology (2023)

Izanne Roos, MBChB, PhD; Stella Hughes, MD; Gavin McDonnell, MD, PhD; Charles B. Malpas, PhD; Sifat Sharmin, PhD; Cavit Boz, MD; Raed Alroughani, MD; Serkan Ozakbas, MD; Katherine Buzzard, MBBS, PhD; Olga Skibina, MBBS, PhD; Anneke van der Walt, MBBS, PhD; Helmut Butzkueven, MBBS, PhD; Jeannette Lechner-Scott, MD, PhD; Jens Kuhle, MD; Murat Terzi, MD; Guy Laureys, MD; Liesbeth Van Hijfte, MD; Nevin John, MBBS; Pierre Grammond, MD; Francois Grand’Maison, MD; Aysun Soysal, MD; Ana Voldsgaard Jensen, MD; Peter Vestergaard Rasmussen, MD, PhD; Kristina Bacher Svendsen, MD, PhD; Ismael Barzinji, MD; Helle Hvilsted Nielsen, MD, PhD; Tobias Sejbæk, MD, PhD; Sivagini Prakash, MD; Morten Leif Munding Stilund, MD, PhD; Arkadiusz Weglewski, MD, PhD; Nadia Mubder Issa, MD; Matthias Kant, MD, PhD; Finn Sellebjerg, MD, PhD; Orla Gray, MD; Melinda Magyari, MD, PhD; Tomas Kalincik, MD, PhD; MSBase Study GroupDanish MS Registry Study Group; Jose Antonio Cabrera-Gomez; Etienne Roullet; Cees Zwanikken; Leontien Den braber-Moerland; Michael Barnett; Suzanne Hodgkinson; Justin Garber; Mark Slee; Pamela McCombe; Bruce Taylor; Richard MacDonell; Jennifer Massey; Vincent Van Pesch; Danny Decoo; Barbara Willekens; Yara Fragoso; Julie Prevost; Alexandre Prat; Marc Girard; Pierre Grammond; Catherine Larochelle; Jiwon Oh; Patrice Lalive; Claudio Gobbi; Dana Horakova; Eva Havrdova; Radek Ampapa; Guillermo Izquierdo; Sara Eichau; Jose L. Sanchez-Menoyo; Cristina Ramo-Tello; Yolanda Blanco; Albert Saiz; Sarah Besora; Vahid Shaygannejad; Elisabetta Cartechini; Matteo Diamanti; Maria Pia Amato; Daniele Spitaleri; Francesco Patti; Clara Chisari; Emanuele D'Amico; Lo Fermo Salvatore; Bassem Yamout; Samia J. Khoury; Abdullah Al-Asmi; Maria Jose Sa; Talal Al-Harbi; Rana Karabudak; Recai Turkoglu; Trevor Kilpatrick; John King; Ai-Lan Nguyen; Chris Dwyer; Mastura Monif; Lisa Taylor; Josephine Baker
Adverse Drug Events by Sex After Adjusting for Baseline Rates of Drug Use
Authors: Tamara Rushovich, Annika Gompers, Jeffrey W. Lockhart, Ife Omidiran, Steven Worthington, Sarah S. Richardson, Katharine M. N. Lee
Journal: JAMA Network Open (2023)

This cross-sectional study examines adverse drug events reported by sex in the US Food and Drug Administration (FDA) database after adjusting for drug use by males and females.
Multistep Testing Algorithms for <i>Clostridioides difficile</i> Infection
Authors: Maribeth R. Nicholson, Curtis J. Donskey
Journal: JAMA (2023)

A 10-year-old girl with spina bifida and neurogenic bowel hospitalized for abdominal pain, dehydration, and more than 20 episodes of diarrhea per day. A stool sample test result was positive for Clostridioides difficile by polymerase chain reaction and an enzyme immunoassay result for C difficile toxin A and B was negative. How do you interpret these test results?